Part I of IV: BHRT Seminar Series Mastering the Protocols for Optimization of Hormone Replacement Therapy JointProviders Worldlink Medical and The Foundation For Care Management Featuring world-renowned expert and successful author, Neal Rouzier, M.D. 20 AMA PRA Category 1 Credits 20 Nursing Contact Hours (20 Pharmacologic Hours) 20 Contact Hours Pharmacy Credit *(knowledge based) Worldlink Medical
Course Details This seminar is a workshop utilizing a case study approach designed to help physicians and practitioners successfully and knowledgably treat their age management patients. This intense two-day mini-residency teaches everything you should know about hormones, the various types of hormones (both good and bad) the synthetic (non-human) vs. pharmaceutical bioidentical (human identical) vs. compounded (human identical but not FDA tested or approved). You ll get the real nuts and bolts needed to prescribe hormone replacement therapy (HRT), which ones to use and which ones to avoid, how much, when and why. You ll learn about monitoring and adjusting HRT through case presentations, literature reviews, and open discussions. Emphasis is placed on understanding the difference between normal and optimal levels of hormones based on our medical studies. The Part One Course involves a scientific literature review of HRT, case presentations, and case management requiring audience participation. The first day analyzes medical studies as they pertain to optimizing hormones for both men and women, why we do what we do, the benefits of HRT, and the literature support for optimization of hormone levels as opposed to simple replacement. Day two involves extensive review of 100 cases that involve laboratory evaluation, then diagnosing, prescribing, adjusting, troubleshooting, and discussing hormone therapies for different scenarios for both men and women. We then review the various dosing regimens, side effects, precautions, complications, and tricks of the trade. Your practice of hormone replacement therapy will be based on peer-reviewed medical research and a wealth of clinical experience. This course is the most comprehensive taught on this subject, designed to give you practical information and skills that you can use on a daily basis. The curriculum is an evidence-based program on preventive medicine designed to enhance your diagnostic and prescribing skills when optimizing hormones for both men and women. Although most practitioners are fully aware of the need to replace hormones in cases of sub-normal hormone levels, most have not been trained to optimize hormone levels if the baseline hormone level is normal. Many attendees frequently inquire why a patient is treated with various hormones when the baseline lab test indicates normal. Just as confusing is the realization that the medical literature supports that normal is simply not optimal. A multitude of studies support optimization of all hormones regardless of the baseline levels, both for maintenance of quality of life and for future health benefits. In addition, the medical literature demonstrates that optimization of hormones results in relief of symptoms, improvement in well-being, and a decrease in morbidity and mortality by attaining levels in the upper range of normal. It is imperative that practitioners understand both the need and benefit of optimization, what levels are considered to be optimal, and have command of the literature that supports it. One important aspect of this course is the extensive review of the medical literature that provides the credence and support as to why we optimize with certain hormones as well as avoid the use of non-isomolecular hormones. Remember that normal is definitely not optimal when it comes to hormone replacement and this applies to both men and women. This is the most popular course taught on BHRT, designed to give you information and skills required to best prepare you to know everything you will need to know to start Monday morning. It will forever change your practice and the lives of your patients. The curriculum is an evidence-based program on preventive medicine designed to enhance all you need to know to start BHRT as well as business forms, consents, and HRT booklets to educate patients on the importance of hormone replacement. The curriculum features an evidence-based approach to preventive medicine designed to enhance your diagnostic and prescribing skills when optimizing hormones for both men and women. Advisory: The concepts and practice taught are evidence based (we follow the guidelines from the medical studies that prove efficacy) in contrast to what is taught by some groups whose approach is not evidence based (no justifiable scientific reason for what they are teaching and that which is often contrary to evidence based medicine). 1 Woldlink Medical More Information at www.worldlinkmedical.com 888-222-2966
Course Objectives 1. Evaluate and become proficient in the medical literature that supports biologically identical hormone replacement in contrast to chemically altered hormones and realize that all hormones are not the same as demonstrated by the literature. 2. Implement therapeutic management of andropause based on studies reported in prestigious medical journals. 3. Identify the types, doses and methods for administering testosterone to men and women. 4. Discuss the prescribing of testosterone for men and women, including complications, precautions, potential side effects, and monitoring. 5. Discuss the utilization of Finasteride, Dutasteride, and Anastrozole as they pertain to the management of side effects of testosterone. 6. Identify the uses of melatonin including correct dosing and monitoring. 7. Apply strategies for the effective uses of DHEA and pregnenolone including correct dosing and monitoring. 8. Evaluate new evidence that contradicts the experts conclusions from the HERS and WHI trials on estrogen treatment in women. 9. Demonstrate an understanding of the health benefits of estrogen and progesterone in contrast to the health detriments and harm of synthetic estrogen and progestin. 10. Describe the types, doses, and methods used to administer estrogen and progesterone. 11. Understand that different formulations can affect absorption, efficacy, side effects, and complications. 12. Review lab tests that demonstrate that some compounded hormones are poor in quality, not micronized, and result in reduced efficacy and low serum levels. 13. Discuss recent literature, questions and answers that demonstrate the beneficial effects of hormones such as improved function and healing and a better quality of life. 14. Explain current concepts of thyroid replacement and compare and contrast different options available for thyroid replacement as supported by the medical literature. 15. Recognize various methods of testing for thyroid deficiencies and what labs and approaches are best. 16. Discuss and analyze interesting and complicated cases that involve hormone replacement therapy, which hormones are absorbed best, and when to use oral vs. transdermal HRT. 17. Recognize the difference between normal levels and optimal levels of hormones and the benefits or detriments as demonstrated by current medical studies. 18. Implement best clinical practices in diagnosing, prescribing, monitoring and adjusting of BHRT for improved function and quality of life. 19. Develop and apply business management principles to set up a preventive medicine practice. 20. Analyze and review treatment protocols in case management for both simple and complex cases as it pertains to BHRT. 21. Evaluate the lack of peer-reviewed studies for any compounded hormones in comparison to the standardized, pharmaceutical bioidentical hormones which are the only natural hormones utilized in medical studies. 22. Describe how to write prescriptions for compounded hormones to pharmacies, and how different formulations can affect absorption, efficacy and side effects. 23. Correct any insufficient or inappropriately prescribed hormone therapy to conform to scientific standards in order to optimize hormone levels. 24. Implement current strategies into your practice to improve the level of care and patient compliance in the treatment of adult hormone deficiencies. 25. Assure that prescribed hormones meet industry standards based on attaining adequate serum levels and symptom improvement. 26. Understand that some compounded hormones are poor in quality, poorly absorbed, not micronized, and usually prescribed in very inadequate amounts to conform to scientific standards of maintaining therapeutic levels. 27. Understand that biologic endpoints (lab tests) are the only reliable assessments to assure that the HRT prescribed is as efficacious as pharmaceutical bioidenticals utilized in the literature. 28. Realize that it is the responsibility of the medical practitioner to assure that their compounding pharmacy dispenses only high quality hormones from either a European or U.S. made source in order to guarantee efficacy and therapeutic endpoints. 29. Apply current prescribing strategies for maintaining adequate hormone levels, knowing which serum levels to follow, which tests not to use (saliva), and the literature supporting each. 30. Review the literature describing anti-aging and how it pertains to hormones by improving function, healing, and providing a better quality of life even though no therapy is FDA approved for anti-aging. 31. Analyze new treatment protocols to best diagnose, prescribe, monitor, and adjust BHRT for improved function and quality of life. WorldLink Worldlink Medical 2
Agenda FRIDAY 7:30 AM - 8:00 AM Registration 8:00 AM - 10:00 AM Introduction to Hormone Replacement Therapy Importance of optimization of all hormones as per the medical literature Health and quality of life benefits AMA statement on anti-aging The best preventive medicine to maintain well-being and reduce morbidity & mortality Normal is not optimal, and optimal is best Understand that simply replacing hormones to normal levels is not what is best for health and well-being Examples of optimal labs vs. normal labs HRT replacement: Have we been doing it incorrectly all this time? What we should know about hormones but were never taught Why we do what we do based on the medical literature 10:00 AM - 10:15 AM Break 10:15 AM - 11:15 AM Testosterone: Safe and Necessary for Both Men and Women Various types and doses but which is best, simplest, easiest Applications: How, where, and when to apply and why Complications, precautions, side effects and monitoring 11:15 AM - 2:00 PM Lunch Break: Non-CME Compounding Pharmacy Introduction Luncheon and Tour 2:00 PM - 4:00 PM Testosterone: Safe and Necessary for Both Men and Women, Continued What levels are normal and what levels are optimal PSA, free PSA, and prostate cancer DHT, Estradiol, Finasteride, Anastrazole, 5a-reductase inhibitors, & aromatase inhibitors A literature review, indications & contraindications, and blood clots? 4:00 PM - 4:15 PM Break 4:15 PM - 5:30 PM Testosterone for Women: The Feel-Good Hormone for Women Too It is not just a male hormone What types, doses and levels work best Application: How, where, when and why to apply Side effects and treatment with Spironolactone Extensive literature review 5:30 PM - 6:00 PM Question and Answer SATURDAY 7:30 AM - 8:00 AM Registration 8:00 AM - 9:00 AM Melatonin, DHEA and Pregnenolone: All Hormones Provide Health Benefits Melatonin: The great sleep and immune enhancer Treatment & prevention for cancer, HTN, migraines Administration & monitoring: How much is enough? DHEA: How DHEA improves health and longevity DHEA: How to prescribe, monitor, and adjust for maximum benefit A literature review supporting optimal levels Side effects and use of spironolactone Pregnenolone: The mother of all sex hormones Memory enhancer? And what about cancer? A literature review of these hormones Administration, monitoring and adjusting 9:00 AM - 10:30 AM Menopause: Estrogen & Progesterone Are Absolutely Necessary for Health & Well-being 3 Woldlink Medical More Information at www.worldlinkmedical.com 888-222-2966
Natural vs. synthetic estrogen; risk vs. benefit a literature review of types of estrogens Health benefits and feel-good benefits of HRT Don t fear it: The most recent consensus, timing is everything Informed consent for stopping HRT and harm of hormone deprivation What types of estrogen: How, what, where, and why? ACOG and NAMS: No study to show efficacy of BHRT wrong! Doses, monitoring levels, adjusting, selection: What works best and when The importance of serum monitoring Transdermal vs. oral: Benefits and harm of each Does age make a difference? Does timing make a difference? Understanding MMP Indication and contraindications: Problems with synthetic vs. bioidentical vs. compounded New evidence that contradicts the conclusions of the WHI Trial and HERS Different strategies for managing PMS, perimenopause, menopause, bleeding, problems, side effects and complications = no man s land 10:30 AM - 11:00 AM Progesterone: Just as Important as Estrogen Absolutely necessary in ALL women at whatever age A literature review: There is not one negative study Protection against breast cancer, uterine cancer, heart disease MP MPA, natural vs. synthetic, safe vs. unsafe If some is good, more is better? Absolutely Dosing, monitoring, adjusting, and the importance of optimization Serum vs. saliva testing and harm of inadequate dosing 11:00 AM - 11:15 AM Break 11:15 AM - 12:15 PM Thyroid: Why Patients Demand It The most misunderstood and ignored hormone Thyroid test is normal but symptoms persist. So now what? Types of hypothyroidism and which ones you miss Does your patient need their thyroid to be optimal? You bet! Understanding lab values What is responsible for low thyroid symptoms when TSH is normal? Types of thyroid hormones, dosing, monitoring, and adjusting Treatment of fatigue: Treat the TSH or Free T3 or the patient? Endocrine viewpoint (labs) vs. patient perspective (symptoms) Signs and symptoms of sub-optimal thyroid replacement and treatment Literature support for optimization: Treat the labs or the patient? Improvement of health and well-being through optimization The consequences of low normal Free T3 as per JAMA 12:15 PM - 1:15 PM Working Lunch Break: Setting Up My Preventive Medicine Practice - What Works and What Doesn t Outline, worksheet, forms, letters and consents How to bill Different types of programs Necessary equipment Evaluating pharmacies and laboratories Products and services Everything you will need to know before starting Monday morning 1:15 PM - 2:15 PM Thyroid: Why Patients Demand It, Cont. 2:15 PM - 3:15 PM Summary & Review Interesting cases HRT indications, contra-indications, risks, benefits Side effects, problems, complications Dosing & adjustment of various types of HRT with lab reference comparisons Cautions, suggestions, things to do, and mistakes to avoid Worldlink Medical 4
3:15 PM - 3:30 PM Break 3:30 PM - 5:30 PM Case Management: Everything You Should Know Administration and appropriate dosing The nuts & bolts for practicing HRT correctly: Everything you should know Administration and appropriate dosing Monitoring the patient and adjustment for optimization Proper case management, problems and complications Mistakes to avoid Lab interpretation & lab comparisons Different optimal levels for different laboratories 5:30 PM - 6:00 PM Question and Answer SUNDAY 7:30 AM - 8:00 AM Registration 8:00 AM - 10:00 AM Case Management: Everything You Should Know Proper case management, problems and complications Mistakes to avoid Lab interpretation & lab comparisons Different optimal levels for different laboratories 10:15 AM - 11:15 AM Review of Practical Application Administration and appropriate dosing The nuts & bolts for practicing HRT correctly: Everything you should know Monitoring the patient and adjustment for optimization Proper case management, problems and complications Mistakes to avoid Lab interpretation & lab comparisons Different optimal levels for different laboratories 11:15 AM - 12:15 PM 100 Written Questions and Answers with Discussion 12:15 PM Adjourn 5 Woldlink Medical More Information at www.worldlinkmedical.com 888-222-2966
About the Instructor Neal Rouzier M. D. Dr. Neal Rouzier is a pioneer in Bioidentical Hormone Replacement Therapy, practicing almost since its inception in the early 1990 s. He has dedicated his life s work to uncovering the medical literature that supports safe and effective protocols for unique and personalized patient care. He is the Director of the Preventive Medicine Clinics of the Desert, specializing in the medical management of aging and preventive care for men and women. He has treated more than 2,000 patients with natural hormone replacement therapy and is recognized as a renowned leader and expert in the field. Membership Claim the exclusive benefits of Worldlink Medical membership with full text article searches through EBSCO Health. Learning is continuous and members of Worldlink Medical have access to extend this process through unlimited access to Medline Complete and CINAHL with access to over 3,000 journals. The power of one is great, the power of many is greater. Members of Worldink Medical are deeply committed to making an impact as a community of experts. Membership is included with your course registration fee and includes access to all articles referenced in the Four-Part BHRT Series. Certification Certification through Worldink Medical provides physicians and healthcare practitioners with the education, assessment and credence needed to practice hormone replacement therapy. The certification is designed to evaluate proficiency and competence in applying newly learned skills through written questions, case studies and demonstrations of how the skills apply in clinical settings. More information can be found at www.worldlinkmedical.com. Worldlink Medical 6
Worldlink Medical Course Dates Part I Part II Part III Part IV August 11-13, 2017 Salt Lake City, UT September 22-24, 2017 Boca Raton, FL October 27-29, 2017 Park City, UT December 1-3, 2017 Salt Lake City, UT October 20-22, 2017 Salt Lake City, UT Early Bird Price ($1,195) 30 Days before course Early Bird Price ($1,195) 30 Days before course Early Bird Price ($1,195) 30 Days before course Early Bird Price ($1,195) 30 Days before course Initial Enrollment ($1,295) Initial Enrollment ($1,295) Initial Enrollment ($1,295) Initial Enrollment ($1,295) Past Graduate ($675) Past Graduate ($675) Past Graduate ($675) Past Graduate ($675) Staff Member ($675) (RN, MA, Office Manager) Staff Member ($675) (RN, MA, Office Manager) Staff Member ($675) (RN, MA, Office Manager) Staff Member ($675) (RN, MA, Office Manager) Registration Form Credit Card Type Name Master Card Visa American Express Discover Credentials (MD, RN, RPh, etc.) Name on Card Expiration Email Card Number Phone Expiration Date X Security Code How did you hear about us? Speciality Signature If billing address for credit card is different than address listed on the form: Address City State Zip Address How would you like to receive your course materials? City State Zip Printed Digital Both Register online at: worldlinkmedical.com/live-cme-courses/ 669 W 900 N, North Salt Lake, UT 84054 888-222-2966 F: 800-865-2387